title: Acoustic, aerodynamic, and perceptual analyses of the voice of cochlear-implanted children.
abstract: OBJECTIVE
  The purposes of this study were to compare, from an acoustic approach, the voice of cochlear-implanted children and the one of deaf children using conventional hearing aids (HA) to a control group; to characterize, from an aerodynamic approach, the voice of congenital/prelingual profound deaf children wearing cochlear implants for at least 3 years and implanted before 3 years old; and to classify, from a perceptual approach, the voice of implanted children, of fitted children with conventional HA, and of normal hearing (NH) children as "normal or dysphonic voices."
  
  
  METHODS
  We analyzed 78 voices of children aged 5-13 years using EVA 2 workstation: 38 children with NH, 40 deaf children wearing HA and cochlear implants for at least 3 years and being implanted before 3 years old. Acoustic parameters were measured from a sustained vowel /a/ and speech production and aerodynamic parameters from a set of 10 syllables /pa/. Perceptive assessment was performed by a jury of experienced listeners using G component of Hirano's GRBAS (Grade, Rough, Breathy, Asthenic, Strained) scale.
  
  
  RESULTS
  Some acoustic parameters differ significantly between NH children and deaf children's groups with HA and cochlear implants, whereas other parameters are similar between control and cochlear-implanted groups. Analysis of aerodynamic parameters indicates that the phonatory physiological behavior of the implanted group is following an evolution within the norm. Finally, results of perceptual analysis reveal that the implanted group's voice samples can be classified in the first two grades (G0=9, G1=11, n=20) according to the G component (overall dysphonia) of the GRBAS scale.
  
  
  CONCLUSIONS
  Cochlear implants may improve the majority of acoustic parameters of the voice better than HA for deaf children. Glottal and laryngeal efficiencies were significantly increased with the chronological age and the time of wearing an implant. Results suggest that voices of implanted children in our study do not reveal vocal characteristics traditionally used to determine the dysphonic voice.
authors.affiliation: Deaf children with associated disabilities Service, Leopold Bellan's Medical Center of Pediatric Phoniatrics and Deafness, La Norville, France. harold.guerrero@free.fr
authors.forename: Harold A
authors.initials: HA
authors.lastname: Guerrero Lopez
authors.forename: Michel
authors.initials: M
authors.lastname: Mondain
authors.forename: Benoit
authors.initials: B
authors.lastname: Amy de la Bretèque
authors.forename: Patrick
authors.initials: P
authors.lastname: Serrafero
authors.forename: Catherine
authors.initials: C
authors.lastname: Trottier
authors.forename: Melissa
authors.initials: M
authors.lastname: Barkat-Defradas
mesh_terms: D000162:Acoustics; D000293:Adolescent; D000367:Age Factors; D000704:Analysis of Variance; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000295:instrumentation*; D003054:Cochlear Implants; D012048:Correction of Hearing Impairment / Q000295:instrumentation* / Q000379:methods; D003638:Deafness / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D055154:Dysphonia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006310:Hearing Aids; D006801:Humans; D007600:Judgment; D008297:Male; D019986:Persons with Hearing Disabilities / Q000523:psychology / Q000534:rehabilitation*; D011237:Predictive Value of Tests; D013018:Sound Spectrography; D013061:Speech Acoustics; D013065:Speech Intelligibility; D013067:Speech Perception; D013068:Speech Production Measurement; D014833:Voice Quality